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AF - 37679e r Ca.ty of Fridley, Minn. BUILDING PE�IT N° 5 s� o ��: _�.� � � � ` Owner: �� Builder �� , . �� � Address ...... Address — LOCA, O ILDING No. _�_ Street .�—._ Part o t Lo���� � Addition or Sub- � onr ,�r-�-' C�.�-, ��� Coraer Lot .__ Inside Lot ._._.._ Setback ��� Sideyard .�aG.L�._�� Sewer IIevation � ._._ Founda.tion IIevation DESCRIPTION OP BUILDING To Used � Front �� �Depth �� Height -�'� Sq. F� ��� Cu. Ft e�� Fr nt Depth .—._�it Height .._._� Sq. Ft — Cu. Ft �v Type of Construction A�!��_� F�t. Cost �.��� � be Completed — In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provlsiona of ordinanc� of the dty of Fridley. .�' .� In consideratioa of tt►e payment of a fee of $ _, permit is hereby granted to to construct the building or addition as described above. Thia permit is granted upon the express condition that the person, to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said buflduig, or any part thereof, shall conform in all respects to the ordinances of FricIIey, Minnesota regarding loca.tion, construction, altera.tion, maintena.nce, repair and moving of buildings within the dty limits and tkus �rmit may be revoked at any time upon violatt'o� any of the provisions of said Ordinanc:es. � a /, / / �� NOTICE: Thb permii does � eover �hs coestrueHon, iasta�afion for wirieg. Plumbing, ges 6eaHng, sevrer e� wate�. Be sore to see tha Buildiue Inspeetor for aeparate permhs for t6eae items. ', " 4 �'�/ /`/l� b� (T � �-�I i���lt� �� � , � �' �p�=c�,Taov �o�a suz�n=�vG pE�aT C�3'Y 0�' Pc'ItIDS,EY, NLZL+�NESOT� a�me� � s Name � �, � � .�_ _ � A,D ��� � A� Builder i'`�, �:. �.� �a.� � �'� �.-o, '� Adciress_ �.�e � � � � �,�„�����.�Adcl�ess .�� .� 9 , ��.�.�.� �,� L�ATION OF BUILDING Noe � L� �street � 1-� � �. �L� :lid � - 3�ast or r,ot . _ - Lotc ��- /_ �„� 3�� Block %� Addit3.on or Subdivis j on ��Aa �� �, s Co�cner Zot �� �nside Lot Setback�Side-Yard � ��'�� SEFr�TER ELEVATION FOUNDATION ELEVATIOiiT Applicarit at�ach to �this ro�m Certi�icate of �urec�y of Zot and proposea build3ng� loca�ion. DE�CRIPT30N OF StTI�D7NG To Io,e used as o �� �'.�' �'ron� � � °- � � Depth �. � � i3eigh� ' � Sq e Ft .�� �O Cu . Ft .�•��+ �'ront_______ Dep•ch �eight Sg. Ft. Cue Ft. - �ype o£ Construc�ion �,l���_,_„ Es�3.ntated Cos•�,�,�e� � y o be Completed� � C.�, �' a �� , j „ The undersignad he.reby ma}c�s applicat�.on fo�c a permit �or the work herein specif3ed, agree�.ng to cio all work in stric� accordance with the C�.�ty of Fridloy Ord�.nances and ruling o� the Depar�ner�t of Build- ings, and hereby declares that all the fac�s and scepresen�a�lons e,�cated in this ap�lication ase true a�nd co�roc�. ; _ , � �.��-� C� �--.�r.,c-�� �� A � a�� (3ched�ile of Fee Costs can be found on the Rev�rse Side). � /"`1 � , _._. ., , .. � . . � ,� , BUILD�NG PERMST FEE SCAEDULE Sec�ion 2. The Tnspector o� Buildir�gs shall� before isauing any pe�3n�� �or the erec�ioa o£ any building or structure, or for any addition to any ox�s�ing bu3lding or st;;�cuc�wce, or for any alterations or repa�.rs to any ex�.s�cing building or_struc�ure, upon application �here�or, require �he pay:nent hy the applicant �or such permit of �ees to the amount herein beloow set forth and iz�. the r�nanner herein pxovided to-wito 2.1. r o= any auch per�n3.t for the erection ofc any fire-proo� building, o�:he� than a garago, warehouse, factory o� grain elevator, or �Eor the _ -��ecfcion of anp- �ire-g�:�oo� addition, for similar occupancy, tQ any' exist� ng bu�Llding sha11 be at the� rate of $1.40 for each ono thousarid cu3�ic �eet, or fraetioa thereof, 3n such cubical contents. 2.2. For any such porm��t �or the erec�ion o� any fire-proof garage, warehouse, �ac�oTCy or grain elevator, or �or the erection ox ar,y :cire- proo� addition, ior similar occupancy, co any existing bui�.ding shall �e at the ra�e or $1.25 �or each one thousand cub ic �ceet, classi�ie� as "�ireprool" by �ect3.on 502 of the M�.nneapolis Builc�ing Code.. HOUSES 2,3. For ariy such pesmit �or �the erection of any non-�3.�eproof build- �.ng other than a garage, warehouse, �ac�ory or grain elevator, or any non�•r"ireproo� addi�jon, for s�.milar occupancy, to any exis�cing build3ng Permit $1.00 for each one thousax�d cubic feet. c�GEs 2.a. �or any such permit for the er�et3on o� any non-fireproo� �a� %�=��8�; °����� or gra n e eva�or; or �or tl�e erection af - any non-f�.reproo� addi�ion, sor eimilaa��cc occupancy, to any existing building or for each such bu3lding or addition. Nin�ty Cen�ts for each one �housand cubic �eet or graction ichereo�, 3n tho cubical contents thereof with a m�.n�mum o= $4.00. �'or the purpose o� computing fees for building permi�� the cubical con- �ents o� any buildj.ng or addition to a uniform height throughout by multiplying the ground a�cea covered�iram a point aix (6) inches below the floor line o� t1�e basement or cellar to the average height of the upper sur�ace or tc 'cYie average heigh� of the �coc�f surface of the main gable of a pitched reooi. 2.5. For repairs�or alterations to an exiating structure, the cee shall be at ithe ra�e of $3.00 per each Five Hundlred Dolla�s .($500.00? or :Lractio� thereoi in the cos� o�f all proposed worl�. 2� 6. 3n r�o case sha11 �he fee charged �or any pesmit as set fo�cth in Section 2 be leas tl� $4.00. ^ �. 4 ,, -- � . .a. ., . .^. i .._ .: ._ .;. :. _ ___ . . .. ' _ ___' ' " .. . _ _ -. . _ .,,., . -.- ..� . � . .,.... � ;.,�: `. " ' . . ..:� ' �. 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";,;.:, �y �'! � � -_ � cr �' �� ��j� tl � � F� �-_ � �� � � ��M ���� ��o � r � � p. m �, � � � S� 5' � �, °� � � . � � �� � � � � � .:i. � . � '�,y - °�,a' � � e. � � • �/ � � i. � 0. , .._e ° � - Dd6 �v HEAT LOSS CALCULATIONS DEPARTMENT OF Weatherstrips A.S.H.V.E. Constructioa No. Guide Windows I Doors Reference Out. Wall Int. Wall Cxiling R i Yes—No Yes—No 19_ !I, FI•� k,tF`��; Room � Length ;'-"` Width ���Height ! Windows and Doors—Crackage an Area �Yidth Helght No. o[ Llneal f. Area rr�` No. o[ pane o[ pane lighte ot crack eq. ft. ''e` wsw �t, 4�` . � ,^' '� � 6- �?�.'2..��� (i . �y� A ,�' �,,, � „� ,e+'� �V� � �o � �, ��� �,� �,, � �,�� f, � �'6 � � c�f. B�, � Infiltration Glass Eap. wall � Net esp. wall Int. wall Ce�ling Floor . Total Btu. . ft. E.D.R. or sq. ins. W.A. Leader area � F7•� ,� �"��,.o� �Room � Length � Width Windows and Doors—Crackage and Area Wtdth Helght No. oL Llneal ft. Ares No. ot pane ot pane Ilghte ot crack eq. ft. � � �� ��' � � � � �. �. �.-.a- � �p" -Y � � �,�v 9 f� � � �r � � � � In6ltration ��.-� Glass Exp. wall � Net esp. wall Int. wall Ceiling Floor Total E � � � Height .�3`� �°. �� `�� � Coef. Bha Required sq. ft. E.D.R, or sq. ins. W.A. Leader area � FI•� ;��';,���.:� Room � Length �/ W�dth Windows and Doors—�rackage and Area Wldth Height No. ot Lineal ft. Aree No. ot Dane ot pane Ilghte ot crack eq. ft. � Infiltration Glasa Exp. wall Net eap. w Int. wall Ceiling�''� Floor � Tot B �` � � �� Coef. Btu Required sq. ft. E.D.R or sq. ias. W.A. Leader area ` _-�� NIINNEAPOLLS. MI1VN. Insulation f Floor Kind How Applied Fl.� '��'° 1�,�'�`� '� Room Length ��� �� Width �� �� Height �"� Windows and Doors—Crackage and Area Wldth Aaight No. ot Lfneal ft. Area � ot pane ot pane llBhta ot ciack eq.kft. ,.,' � +�� �e"� �' �-'.�'' � ys�� '�+'* ?�8 l � Coef. Btu :t egp. wall (� `D f s t. wall ;I�IIIg ,��`:' f�r_ : oor � ��' % �� � ;� `�Y �_ ;^`s ►tal Btu. "d :quired sq. ft. E.D.R. or sq. ins. W.A. Leader area FI•� �',.�' ��� � Room ( Length /,�- ��' Width ;%`� '-'' Height e- Windows and Doore—Crackage and Area Wldth Helght No. of L1nea1 tt. Area, �F`" ot pane of pane ltghte o! crack eq. ft. � � � � �.,� �' . � �� o � � � p. wall � :�' ,h` :�` '% ;t esp. wall ,���.�;:� �� �' :. wall iling _:� � �,� ,, , „� oor �'`' � ' �, �� " �'� �� .�' v.� '� tal Btu. �=' :quued sq. k. E.D.R. or sq. ins. W.A. Leader area �.� �' � t�� �� Room I Length �,� Width � a� Height,f�'' Windows and Doors—Crackage and Area �� Wtdth Height No. of Lineal ft. Area ' ��` of pane ot-pane ltghte ot crack eQ. tt. _ '� ey � � � � �9' �l �'°�, �filtration ,�' �ass '"� ° <� .A� ap. wall ,� ..�` �?�' .� ,�' f et exp. wall +`�,�, "'� �t. wall eiling `' .��. 'loor A � � �r� a 'otal �tu. ;equired sq. k. E.D.R. or sq. ins. WA. Leader area Btu � 7 � CYT� 0�' ���E'� �t1�D� ��PE�YI�A D�P � �60m345A w-��� �� ' T. L. Construction C�any 3219 Penn Avenue North Minneapolis, Minaesota �e�t�,��o June 14, 1962 �teo B�si�df�ag P��t �oa 5540 Adtlse_ss 609 Cheryl St. 1Q. E. (Dwelliag) s��� $25.00 ..� �� �b�ve c.sp�i�ed bui�.dir�g pe�rm�Lt �s be�a r�ady i� � �a�fic� for qn�it� �a�te ti.mep a�ad we w�u�,d �p�rc�ciae� i� ��y mnch iE y�u wou� d kia�d�y take ca�a of tY�e m�.�ter e� y�� ear� ieet a�avextiie�ce a �s q� l��wo �he b�ia,cii� permiC ah��c1 be p�t�d �� sa� ae c���+act��m st�.�ts a �'�ure v8z� t�u:,ye �a � o Jer�s� Buii4�itag �caep�ctor 11�T e cke This permit ha.s been in our office since September 12, 1961. We have sent yau previous reminders aad we still have not heard from you. This ia absolutely our last notice ta you and if we do not hear from yau by return mail, other action will have to be taken. � � �� - �:��� . � � ��:----�- , . _ ��-� , I I � �� . �._.; Jvly 3, 1952 Mr, Laui$ iirbanski 33I5 Bsyanr A�renue Sont6 Ili.naespoli�, Miinmestrts ae: Building pesmit �o. 5544 6t� Chergl St. H. E. �2S . � ,_„_._. Dea� Sir: Ia our teieg&ane eonversatiaa a week or so agr�, ga� psom%sed t� ccme into this oifire �ncl pisk ap elae ab�e�re capti� bnilding permit which h�s beea se�dy sin+�e September 12, �9�2. �.s of this date, this germit still 'das aot beea r�ceipted by you. AG�:cic�e Please give tttis aratter �aur �ery+ preff�ed attenticm. Yaurs verq truly, ALLEN G. JENSEP Suildiag Inspector � sue�ecr PERMIT NO. c�ty of Fr�aiey , ` AT THE TOP OF THE TWINS g U I L Q I N G P E R M I T • CEIPT NO. � � ; V ______ COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC. i � (1 i � __--� /'�'1 •� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L % , 812-560-3450 910-F15 ].]�1.8�7'� � � JOB ADDRESS 609 Cheryl Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. 1, 2, 3, 4 W Riverview Heights SHEET 2 'PROPERTYOWNER MAILADDRESS ZIP PHONE Gerald Kostryz 609 Cheryl Avenue N.E. 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO. Inter City Bu:ilders 2500 Murray Avenue N.E. 789-9009 4 ARCHITECTOR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK � NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' x 22' Garage 9 CHANGE OF USE FROM TO STIPULATIONS provide a hard surface driveway. Release gotten from neighbor. Call for rough-i.n inspection before siding building. Must meet all flood proofing regulati.ons. �� WA�NHG SE1�RA`TE PEI�MITS REQUIRED FQR 1rVtR1NG, 8afore digg�ing call l�c�� utiiities HEATI NG, PL�IN�lNG ANQ StGNSm TfIEFHONE • EIECT�?fG -�,S �tc. I�EQ�IlRED BY l.�►W SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STAL�S GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HERE�N OR NOT. THE GFANTING OF A PERMIT S3 � 9O%. ZO yS`�.. 9S DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY THER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE R ORMANCE OF CONSTRUCTION. � S2�-.�-2 PLAN CHECK FEE TOTAL FEE � ' $23.07 �SIGNATURE FCONTRACTORO AUTHORIZEDAGENT (DATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI /�-` �� �, BL�G WSP qATE � . 205.157 Ordinance No. 555 Cont. � ... .3� • t� SECTIO:I 7. �'�dminisrration; Application for Issuance of �pecial Permit:s �nd Variances � (a) Administration; The zoning administrator sha12 sdminisree and enforce thj.s,ordinance. . ., (b) Special�Use�Permit; A Special Use Permit shall be . applied �or and obtained prior to the construction, � erection, addition or alteration of any obstrucCion wholl.y,or partly in.the Preservation District. . (c) APplication for Permit; Application for Special Use Permits under ttiis ordinance shall be made by � the ot�ncr or o�•mers of the land, in duplicate to the zoning adniinistr�tor, on forms furnished by Llie City and shall be accompariied inieially by the City and shall�be accomPanied initially by such of the follocaino information, data and plans, as is deemed �• necessary by the zoning administrator for determina.rcg . compliance caith this ordin3 nce, and for determining the •- effects of�the prmposed acCivi.ty in the Preservation Distric4�and the buildability of ttie particular site �gs for the proposed imprQVement, use or abstxuction. (1) Plans surface v'iew) . incl.udina a survey by a Minr�nesota re�istered land surve or, showing elevations or contours of the ground, pereinent ob.struceio� elevations, size, location.special. arrangen�ent of zll proposed and e:cisting obstructions . on the site, in relaeion to existing and proposed obstructions to the channel location, location and elevations of the streets, wa�er suppl.y and sanitary facilities, photagraphs showing existing.land uses and vegetation upstream and downstream, and soil types. (2) Specifications for building construction and- mater3.a�s, floodproofing, filling, dredging, grading, channel. improvement, storage of materials, water supply (including �aithdra�aal and discharge of ground and suirface �ater), and sanitary facilities. � (d) �pplication for ��ariance; Applicatian for variance under Chis ordinance stiall be made by the owner or � • owners of theland, in duplicaCe to the Zoning Administr'ator on forms furtilished by t[�e. City. Variances to the Creek and River Protection Ordinance must only be for reasons of ekceptional circumstances when the strict enforcement ot tliis oxdznance wouZd c:�use undue hardship and strict couformity �aith l-he stan�tards would be unreasonable, im- � •' praetical and not fc�isiUle under the circumstances. Variances gr�nted under tl�is ordinance must be consistent toith the gencral purpose oi thesc standards. Although • variances may be use�l to modify permissable methods of � � ���: , ;-� , CITY OF FRIllLEY ,,� � ' ��,i� AP-F'�.T"CATION FOR RESIDENTIAL BUILDING PER��IITS � �NEW, ALTERATIONS, ADDITION�, OR REPAIRS) �..� � c ;= ;?� '�� ! - :�'; • 'a" " �.��--..- . ;-�:, 01�dFsR: � e/�Q `7 �, d� �fr� � '�� y �. Addres s : � �_��e as � �vL �/9 No.:��� LOT: ,� �� �, °�% CORNER LOT: � T Street: BUILDER: �'�°�' �l �,� ��' ��� Address : ���i L!%/,�� � 0 ``�' ��lS/ Tel. No. � ���� � % .�3 . � / $IACY.: �'L/" ADDITION: ` I(��/�(%I E� i��l �` 1�,./-� ]-S INSIDE LOT: S,^:TBACK: SIDEYARDS: Applicant attach 'to this form 7.tao Certificates of Survey of Lot and proposed building location drawn on these Certificates. - DESCRIPTION OF BUILDING To Be Used As: � /� -� ��� �'�� Front: � Depth: ���' Height: ��v ' r � • Square Feet: e`t Cubic Feet: �o�p(7 Fron t : Depth: Height: � . � Square Feet: Cubic Feet: � � Type of Construction: �_�'j'�� p Estimated Cost: $ ����%.2� 7.b Be Completed: �5�� �!�' � �� Al't. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVEFSE SIDE OF SHEET) The undersigned hereY�y makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side far acl.�litional information. DATE: ,�P � � �� SIGNATURE: 5tipulations: �/. �� r. �s .���.�� �c�.fc. ---��� ,�'c,c rn,�r /vc ,%,���--_ ` � , - � � _. ,��2QlJ� a� 1`'lf!/2�J �u��q�� �%�Il/�C�S9 -� � �-� S� ��' O�'1 _ G� �, �� � �U i� � ����-- ��.� , � �-�- � ��-�`� �`�`�`'� __i ` �l . _, , � �°'� � �.`.-� _m ,�'� � ���! �!���'� � � `��' �� y �► 7 7� � � � BUtLDIt�lG PER(�IIT FEr SCN�DULE SECTION 2. The Inspector of 13uildi.ziys. shall'; bcfore i.ssuing permits for the erection of any buildiriy or structurc, or for any addition to any existing building or structurc, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applivant for such perniit of fees to the am�unt hexein below set forth and in the manner herein provided to-wit: NEW CONSTRUCTION: Single I'amily fiomes and Garages: $4.00/1,000 cubic feet.. PLAN CIIECY.: 25 percent of building permit fee. DRIVEWAY D�PRESSION: (Concrete Curb 5treets Only) Alter�yate A: Removal and replacement of concrete curb and guL-ter only; Driveway width plus 6 feet x$11.75 Alternate B: Removal and replacement of concrete curb and guitter and install a 3 foot wide approach with - � 6 inch depth; Driveway width plus 6 feet x$15.40 �DDI T IONAL I NFOF�"I�T I ON For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplyir�g the ground area covered from a point six (6) inches below the floor line of the basement or th� cellar to the average heights of the up�er surface or to the average height of the roof surf.ace of the main gable of a pitched roof. Fo� repairs or alterations to an e:tisting structure, the fee shall be at the rate of $3.Q0 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee_charged for any permit as set forth in Section 2 be less than $7.50 plus $.50 state surcharge. VcRIFICATIO� OF FOUNDATIO� NOTF': Pex'mits for construction will be issued a minir.ium �f 24 hours from the time of aPplication to allow for proper review of the proposed structure and of tY:e construction site. • A Certificate of Survey o� the lot, showing the location of the foundation once it has been constructed will be required before proceedir.g with the framing. CCRTIFICATE OF �CCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a build�ng permit has been issued; and said structure shall not be used or occupied until a Certif.icate of Occupancy has been issued. s� x � _ �! � `` '�1 ' \\ 1 � � u �R� J F- 'N :` �'( �v i a � _ �r R :. � � •� � f a � '� i /' -~ � � o �.�_.' __'_� � 4 � /,^C� w �' • - -- -I �x �t��r W Z. � N .A ! ` ti�> � ij ; o -q V` 1 � p K � � � � � � � � U � �ti � V v v � Z � C1 '-1 V o., .[ a �' .. n ° (� H � `� � 1 �� _ vo �� w � � n o C ^ V Z . l� .L � a 1 � t� ? `� ac ��S � � �0 f. N ti\a� ^` •\�{ � 1.�� 5 � � � `: � � ` i � '•�i • '�; �-� :\ � V.� � �; N � v �'�. � v. `-'"''� \ � � rt µ'�s, .��-''��-.. C• �' J � � � c� � ^L QJ � �� C�q).. i � I- `x `. � � - V V ,x E b � '�J - R -- N r �,� �� � ��X �� x do s Y�� y qe�M�, '_"'� / x a- p v i� X'� �l �A' X� X U �h��.� � � ��� �n �N�� �.� �¢�, � y � C � � � •�. a �, � � � nti '� �� xv � � � ` N � d ��� ^ � � � �i x � �+.� p � 4 p � ' O �4. 'o a Zr �C C `� ' � :a � �. � `�Yn a � � C� o w y, � � � n e � �6• g -� � �, �' � n 3- CQ c�'. � �� � ��H � � � � `� �� 1^' � �� � � �t c c l� i� � NC y� .Z N 4 � ♦ �.. �. � � w L. � � � e � R. t l_ C L � �p o � Z � y� { �' i � � F� � � £' �° a U i � � � n � e _ � � . X � �. % � � f'F n m � r� iA. C�� - -- `� ^' _ —.�.. ^t —�'— � - . —� — ,� a � � 3 � y � 0 n �v ' ( V � ! � ;c i� � t � ! � i a A- ' �I 'V; c AGREEMENT �" � I. G�F� t� , owner of the property located at � =� ��`,, have no objection to the City allowing the construction of a (� to be located at ,� a��� P���v � � without the required cex�tificate of survey that the City ordinarily requires for all new construction. i ' '� ` � , -_ itness �, �� � � � � Sign ,ture � � v ��� c , Address � � /%� � . Date � . . ,,. , , : , . .. _ _ - - ;� _ � .. _ , y � , _. .� - - _ , :, . , , s , : � ,. : � . _ . ,. , . . ..- _. „ , � ,- - -1l�i�n. �L.1�oi t . , _ .. � ,��d ��� g � �►ssoc��t�s Ir�c @ , e�� .: . _ f' 5809 P�rsae Dr1�►e :, _ � Dftice . ��inneav��s 22, �uon. �. � R�GISTERED LAND SURVEYORS T3�2'42nd Ave. No. :_- Phonej iCe.3-824� �-. ' Minneapolis 27'*Minn. - , Mineesota Registration Na. 5�22 Phorte� K�.7-6047 , `_ 1�i- � cT •S AR��FR�`Q� ;���..,.PL L Cc�nQtr�ir�t� nn (`n �;- ' � '� � r :t' 4 _ - � �' � - ' _ � �`"�� _ � r - �, s , , . - , . � �--- � . - ' � � . (',�` �4 ����' %e " z�,. . . � . 1 � � . � . .. �:.. � � ..� � a .-�c: . � . : , ti � � ' . .. �_ . .� ':, . .. . .. ,. -::.�. ., 1'._ . ,:.� ���•y d .. ,,.' -�.. ,.' y.: .y . ' .. : . : - , 4 �.j �� .. ; -,. _ . . ... ��i.. '_.� � . i� ik . . . � - � 'y . --. . . . . . . ' .:. 1 t��.� ` . .. ' d�, ` . . . ' ' .. ) �- - . ' A� - . ... `° :. � 9 JJ . �� �ry, �.w�y °r �.r:."i b� �'::f'"�d" 9.�-k D . I� . ' � � � - .. � s. : � . y , rQ.o. _ � �� �,, ' �.� " _ r ` �s q� - ,�? 4,y �, � � e.. " � - '� v is!! : �� e t�:�� ,�� � .. � 'a � � _ d .- , , \ � . � r� �,., „� s ,,.�. ' d. ��.� `�� ,�,� � ._ "�� - - . . '�� " � ___ �: �.'��. �� �, . - � �, , _ - _ . " �- � - ~' '� o �. ` d •:� I . � a4 �, . - /"� ` � ` r �' ; '. _ ` � _ � y', , '4 . �� . � � � A�''� .7� ` � � � _" . _ �`'..�° > � � y.^ .a %' . .� .. � ��s -. o - _. b � �t•Fe��` . i �a� r a�' , . ��� ✓. ,� � �� . � Zg, � 1 � p�a��g �. - � / �,n �.1,�+�s" �S�/' `m Zi� \ C1 � � �, � � �r � �g�y�.� � t� ` \ �`�.� �. \ < < � . �� , � ���- ll0.a� ��. � 5 J�F��°{`� � � �� �s � ,H .. . � ,^? � _ . . ' ....�-J - � � �f � . . � . . 1 � �.- t . �, �. �$ t • j�a� � ` � � d ,3�.� ��, �� ��E 1 , .�''': ;� � i I hereby certify that this is a true and correct �lat of ` , Lots 1,2,3 & 1�, Block h�, RIVE� NEIGHTS .�D�TTIa�` �,naka' Coun� ? :-iinnesota. , p� �x eaok � �s surveyed b � � � y me this 7th. daJ of Ssptsmber a.D..1961. �• =� _ - �._ . _ . .. ... , _ . ._ . _... f ..�.. ' '�so�+� pasocTo�c Tte. � o�`1sa� a� �z'� � oa�a�. c�oz�2�: so i00' OOS$) S�TioQ �a�P�nH an�3 '�I�2a aad 00' £$ 3o a�.e�c a� �2 aQ T'EEus � ��r�za.s bca��s�Cxa tre o�. suoi�.Qaa�.T2 ao sa�Edas �03 ' S' Z�- �e sus�ECr PE T NO. c�ty of Fridley �- 15 2 3 9 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � r � � REC T NO. � ; L ______ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. ��9 y� � . , i l---- A �r��� `'� CITY HALL FRIDLEV S$432 NUMBER REV. DATE PAGE OF AP�ROVED BV i �� 612-571-3450 910-F15 6/5/79 � � JOB ADDRESS 609 Cl], eryl Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ].-4 W Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gerald KostAhryz 609 Cfieryl Street N. E. 784-2382 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Bob & Sons R�ofin Inc. 4553 %erxes Avenue South 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof dwell' 8 CHANGE OF USE FROM TO STIPULATIONS Roof can be second but not third roof. Install ridged galvanized valleys. SEPARATE PEHMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTFUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPI.IED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�-i3OO �S`. 65 DOE OT PRESUME TO GIVE THORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PR VIS ONS OF ANY OTHE TA E OR LOCAL LAW REGULATING CON- ST CT ON OR THE PERFO AN E OF CONSTRUCTION. $g. OO � PLAN CHECK FEE TOTAL FEE � ��-��� $9.65 SIGNATUREOFCONTRACTOR AUTMORIZEDAGENT IDATE) ' WHEN PROPERLY LIDATED THIS IS YOUR PERMIT �. i SIGNATURE OF OWNER IIG OWNER BUILDERI IDATEI BLDG INSP f1G CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL.BUILDIPJG PERMITS (New, Alterations, Additio�s, or Repairs) OWh�ER: BUI LDER : � � � � ,��,,� , �, ADDRESS: ,(00� �a�,� ,,�g, �, ADDRESS: �s�,3,���,�;� � ,�. � TEL N0: /��l —�.3 �� TEL N0: ��� O��/ Construction Location ST�T NO : o STREET: (...1r.e/�'=��Q ..�,3�' • � . � e LOT: /a �„� � BLOQt: _�_ ADDITION: � � � ��� Corner Lot: Inside Lot; Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIOfd OF CONSTRUCTION Front: Depth: Height: Squ�e Feet: • Cubic Feet: Front : l�pth : H eight: Square Feet: Cubic Feet: Type of Construction: ,�'��� �,� Estimated Cost: $ l, 3��,�a� Zb Be Cbmpleted: � � - Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ . SEE REVERSE 5IDE OF 5HEET The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and ruli.ngs of the Departmexit of Buildings, and hereby declares that all the facts and representations stated in this applica DATE: � -� ° ��' 5IGNATIJRE : Stipulations: ,� � ac� �� � � �s ��� F ����. C��� �� 5������ ���s � r���. ��a��� i- . � ��� ��� ��+-�._ ��1 au z,� ����� v�+�l �_��, , BUILDING PER��IIT FEE SCHEDULE SECTION 2. �The 2nsYector of }3uildings shall, be£or� issuing pernii�s for the erection o£ any building or s�ruciure, or for any addition to any existing buildinq or structure, or for any alteration or rePairs to�any existing building or structure, upon application therefore, require the payment by the applicani: for such per.mit of fees to the amount herein below set forth and in the manner herein provided to-wit: NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1�000 cubic ieet. PLAN CHECK: 25 percent of building Permit fee. _ DRIVEWAY ll�PRESSION: (Concrete Curb Streets Only) ' • Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x�'1�,75 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 faot wide approach with � 6 anch depth; Driveway width �plus 6 feet x$17.85 pll 1 �. 1 �' ' �1 For the purpose of computing fees for building perniits, the cubical contents ot any building or addition, is determined by multiplying the ground area cavered from a point six (6) inches below the floor line of the basement or th� cellar to tize average heights of the upper surface or to the average height of the roof sur�ace of tt►e main gable of a pitched roof . Eor repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 Per each five hundred dollars �� ($500.00) or fraction thereof in tY�.e cost of all pxoposed work. In�no case shall the fee charged for any permit as set forth in 5ection 2 be less than. $?.50 plus $.50 state surcharge. � VERIFICATIO�! OF FOUNDATION NOTE: Permits for cpnstruction will be issued a minimtua of 24 hours from fi:he time of application to a11ow for proper review of the proposed structure and of the construction site. A Certi.ficate of Sur�ey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. ; = � ''► Application for a Ca�tificate of Occupancy shall be made ten (10) days prior to the use or occupancy of �ny structure for which a building permit has been issued;�and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. b r � �' C� � s 7 O n � � �„* m �n r ' � O � � �* O N y '�7 � �n r �y $ x c � A � N h b ,� v m �o b � w y K m � � � � n G � ~ � 7 a r o� N K '*1 W th m e9 a 7�i' � � r m $ � � '�q r �. K � m i a O v� .. N `� 0 0 � G] SC � N�i �11 A 01 la O'll � m u eOr A 9 O� W K~ tC r G o Mp�i M � p ' � � � � p� M Mt �C 7 r► .] M IG+ O W h�i1 W s � N M A M � �1 Q A O�i �1 01 O 41 �f Rf r �.. Q s w m p~ if O � i0 G al a 5 r r o �m.. 4 K r+ w< a o y K z o o r. o a, s m M �Y �3 4 M r p � r ; � M � A G m M e I I I I I I � I� � I I N 81 f/► fA N fA N tA N N N N N r f.. O O lJ� J YI {A Yf Y1 NI A F+ W y� • . . 0 0 0 0 0 0 0 0 0 o tn tn p 0 0 0 0 0 0 0 0 0 0 0 0 0 'v r W 2 n '� tr � C � ta � tst � � r� N 2 G e � � a y tn N N N N N y q q tq y y N N N N N N H O � � a o r � ro� C Z fA M HC � 3 N � O "+1 H y�� H x �K �� bH �� 'b � � H N N M � O O . � C" � t�1 �y y �� .� , M Cy � 0 � 1 � � � � I � � � � � � • W a `'' "' ''' Storiea : �o �r' c�. a °R° � f z � C103ets � � Urinals � � eath �s m 889� Q' � SiNw � M Wash Traya � � �rinking 'o Fountaine ,howers � Floo! Drai � Catch � 9asiz� �. Aueomatic � Wd5$8I r S Gas Appl. Miac. Fixt y� � Gae Ranqe �i M Ofxlet m � m mK R fp ►' M M (� � � m g a� � � � ro � O 8 h1 �� C o�� � N y � G1 ta � � � H � O � Q �] C V � �J� � � � -� � \ � \ �V � O� ro � �. n 'O ro w � '� w K�t n r►M•. c u�ini3 �� °' � "� : 01 f0 01 �'! W h► �Mf�C � Ol0 m� + 0 W � � C � � f0 � � h�+ 7 'O � � �q ��og m _ � � r � m r► � a�i �t n� � m � ��;� O. . r 0, m m � ►� ef R ' r* r . ��q q � m , � MJ ��' � ~ 1 6 � S tl O A 7 � wg4 � �as^ Q w M 0� a r► O �M � 7 M `� Ono O O ' q ? �1nT►� b6 e�'► �C r' Ia�wh � � m �' I K O a o. a � m W �t°.J SUBJECT , ti c�ty of Fridley 7 � � �� � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � r � � RECEIPT NO. � ; y ___._ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC ? � � � � c...�J � � �"'1 � CITY NALL FRIDLEv 55432 NUAABER AEV DATE VAGE o� AVPROVED BV �----� • •'J 612-571-3450 9�0-F15 7/24/9 / � JOB ADDRESS 609 Cheryl Street NE t LEGAL LOT NO. BIOCK TRACT OR ADDITION SEE ATTACHED �esca. 1,2,3,4 W Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rostohlyz 609 Cheryl Street NE 783-1232 0 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sela Roofing & Remodeling Inc 4100 Excelsior Blvd, St Louis Park 55416 4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO. 823-8046 1050 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION C.� ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (21 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, VENTILATING OR AIR CONOITIONING. THIS PEI;MIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT CU. FT AUTHOFI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEFEBY CERT�FY THAT I HAVE FEAD AND EXAAAINED THIS APPLICATION 1 STA�LS GARAGES AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OFDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � 1� 732 �. S7 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVIS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @ STRU TION O TH F MA�CE OF CONSTRUCTION. �y56. %5 Fire .SL' �1 .%3 ��°i` et'� PLAN CHECK FEE TOTAL FEE l/YY0 �Y � License SC $5.00 $64.35 SIGN TUAEOfCON'RACTOAORAUTNOAIZEDAGENT IDATEi WHEN PfiOPE VALIDATED THIS IS VOUR PERMIT �, C� — �� SiGNATU�7EOFOWNERiiFOWNERBUILDERi �OATEi BL G iNSP r�tiTE NEW ADDN ALTER [l �� „ CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: � �� Legal Description: Owner Name & Address: �. �`�' ` Effective 1 / 1 /95 ���`3Z� Tel.# ��b��-� Contractor: SELA ROOFINC & REnnpDFLII�G,-ING . MN LICENSE # 1 C� �7� Address: 4100 EXCELSIOR BLVD. Tel. # � 3��(� �� �@�4l��is application, a Certificate of Survey of the lot, witfi the pro�sed construction drawa on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Length Length I.ength DESCRIPTION OF IMPROVEMENT Width Height Width Height �Vidth Hgt/Ground Sq. Ft. _ Sq. Ft. Sq. Ft. Comer I.ot [] Inside Lot ] Ft. Yd Setback Side Yard Setbacks Type of Construction: �► - �� �za..� Estimat�d Cost: $ � I �''-°-� �`%.�� � Approx. Completion Date: �`�% ��a � � s��°�� (Cost on .8ack) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � C�, G �1'LICANT: Tel. # � `� � - � �' �{ C CITY USE ONLY Permit Fee Fire Svrcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �� 7�� � l� �� $ . °� 7 $ $ �-a� $ $ $ $ $ • �� Fee Schedule on Reverse Side .OUl of Permit Valuatioa (1/lOth%) �.soi$i,000 v�uahan $850 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A” or Ait "B" Above $4�50.00 Canservation Plan Review Fe� Determin� by Engineering Agreement Nscessary ( ] Not Necessary [ ] l3UtLDING P[3RMI'1' FEE SCHEDULI3 �l�hc; (;I�i�f i3uiiding UCticial shall, tx;lorc issuing permits for thc ercction of any buitding c>r structurc, ur ti�r any a�iciiticm tv any cxisting building or stnicture, or for any altcration or rcpair to any cxistin�; l�uiiiiing <�r- structurc, u�n application thcrcfore, rcquire ti�c payment by d�e applicant for such Permit c�t� t�c;.ti tc� the anu�unt hercin t�elbw set fi>�th and in thc niannen c�rein Pr<ividcxi to-.vi(_ '1'O"I'AL VALUI: � t co $500 �501 to �2,000 $2,001 co $25,000 $25;001 co �SO,OOU - $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,OOO,Q00� - $1,000,001 and up rr_i�s $IS (Minimum Foe is $15 plus surchacge) $15 for first $S00 plus $2 for each additional $100 or fradion thereof, to and including $2,000 - $45 for fust $2,000 pius $9 for each additioual $1;000 or fraction thereof, to and inclading $25,000 ' - $252 for fust $25,000 pl�s $6_SQ for each additional $1;000 or fracbiou the�reof, to. and including $50,000 $414_50 for first $50,000 plus $4S0 for each additional $1,000 or fraction thercof, to and including $100,000 $63950 for €�rst -$100,000 plus �$3_SO for each additional � $1,000 or fradion thereof, to and including -$SOt3,000 $Z039S0 for the first $�O,OQQ ptus $3 for each additional $1,000 or fraction th�eof, to and including $I,OOO,IX?0 $353950 for the 5rst $1,OU0,000 plus $2 for each additionai $1,000 or fraction thereof - DRIVEWAY DEPRESSfON ESCROV� (Conccete C�i� Stceets Only) Alternate "A"a Remova! and replaceme�t of curb and gutxec only - Dciveway width plus 6 feet ticnes S 13.50_ Alternate "f3": Removal and rep�acement of curb and gutt� and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VLRiF[CATION OF FOUNDAT[OPT Permits for cvnswction witl be issued a minimum of 24 hours ftom the time of application to allow for proper rcview of tfie propc�scxl �cture and of the constructioa site_ A(;eriific::ite o! Sucvey of tlie lol, shvwing the location of the founciation cmce it hae it has been co�LStructe�i will bc re;yuirul befc�re �x'oceeding with the framing_ _ - -- sue�ecr Pa�ftIG�1T1V0. � City of Fridley � 2 5 7 8 8� AT THE TOP Of THE TWINS g U I L D I N G P E R M I T r � � RECEIPT NO. � • COMMUNITY DEVEIOPMENT DIV. � LV � �� r � � PROTECTIVE INSPECTION SEC. � . � � j �"'1 � CITV HALL FRIDLE� SS432 NUMBER REV OATE PAGE Of pPPROVED Br �.---� • •�� 612-571-3450 910-F15 2/5/98 � � JOB ADDRESS 609 Cheryl Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2,3,4 W Riverview Heights SHEET 2 PROPERTY OWNER MAIL AODRESS 21P PHONE Gerald/Patricia Kostohr z 609 Cheryl Street NE 783-1232 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO Custom Remodelers 474 A ollo Dr Lino Lakes MN 55U14 784-2646 1748 4 ARCHITECT OR DESIGNER MAIL ADDAESS ZIP PHONE LICENSE NO. 5 ENGINEER MAII ADDRESS 21P PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW � ADDITION O ALTERATION �] REPAIR p MOVE ❑ REMOVE 8 DESCRIBE WOfiK Reside Dwelling 9 CHAN(iE OF USE FROM TO STIPULATIONS Install building wrap and have inspection before covering. SEPARATE PERMITS ARE REOUIRED FOR ELECTqICAL, PLUMBING, HEATING, TVPE OF CONST. OCCUPANCY GHOUP OCCUPANCY LOAO VENTIIATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOfi A PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORFECT. ALL PROVISIONS OF LAWS yqLUATION SURTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �lO�OOO �S.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CMARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PEFiFORMANCE OF CONSTRUCTION �IGZ.ZS Fire SC �ZO.00 PLAN CHECK FEE TOTAL FEE License SC $5.00 $182.25 51GNATUREOFCON7RACTORORAUTN0�712EDAGENT IDATEI WHEN PFiOPERIY LIDATED THIS IS YOUR PERMIT / SiGNnTUREO%OWNEAU:OWNEA8UR0ERi iOATEi 9 flLD �NSP �qpTE NEW ADDN ALTER [l [l [l CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 �� �' ��� �� ConstructionAddress: �� �^y ` $' � � Lega1 Description: Owner Name & Address: G ��'o�,1�d �' �fl-�-►�<< � -A- �COSd-� �tr f � Tel. # 7� � � Z�� Contractor: (� �S�v,.� R-P ��e(e � MN LICENSE # � � �/ `� Address: �( 7 � � Qn L-�.o 'I� �'. �,1� �- ��eS Tel. # �g �( - 2� y� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTI�R: Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: �� S G�� r n c� Estunated Cost: $ l�� Dad � (Fee Schedule on Back) Driveway Curb Cirt Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �Z — � 9 APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewe� Main Charge TOTAL STIPULATIONS: Tel. # CITY U5E ONLY $' Fee Schedule on Reverse Side $ /�, t� � .001 of Permit Valuation (1/lOth%) $ j, (' � $.50/$1,000 Valuation $ $1000 per SAC Unit $ , �d $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] � I�.��,�� BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by, th�e .a,pplicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-.wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,�1 to $5�,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fe� .is $21 plus surcharge) $21 for first $SQO ;plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,.O,QO;plus $12.50 for each additional $1,000 or fraction thereof,�:to�;ar�d including $25,000 � $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alter�.ate "B" : Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of 5urvey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. sue�ett PE NO. c�ty of Fr�a�ey 312 7 2 ' ` AT THE TOP OF TNE TWINS g U i L D i N G P E R M I T RE�E�PT N � � ' COMMUNITY OEVELOPMENT OIV. 0��� � ; V �"�� � Q , r � � PROTECTIVE INSPECTION SEC 7, � � � � �"'1 � CITY NALL ffilOLE� SSIJ$ NUM�Eii REV DATE PAGE OF A�PROVED BY �----�: �., 612-571-3450 s�aFiS 8�2�00 / / J08 ADDRESS 609 Cheryl St NE t LEGAI �OT NO. BLOCK TpACT Ofi ADDITION SEE ATTACMED oesca. 1, 2, 3,4 W Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADORESS ZIP PMONE Gerald � Patricia Kostohryz 763-783-1232 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAII ADDRESS 21P PNONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WOFK O NEW � ADDITION O ALTERATION �7 REPAIFi O MOVE O FiEMOVE 8 DESCRIBE WOi;K Replace deck with a 16' x 25 treated wood deck 9 CHANOE OF USE FROM TO STIPULATIONS For stipulations, see attached plans. V�AR 1 �efor� dig�gir�� ��II f�� all utill� I���tic��� �6�dd� �EQui��� �� �wr� SEPARATE PEFiMITS ARE REQUIRED FOF ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SG. FT CU FT. AUTHORIZED IS NOT COMMENCED V!!ITMIN 60 DAYS. OR IF CONSTHUCTION OR WORK IS SUSPENOED OR ABANOONEO FOR A PER100 OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBV CERTIFV TNAT I MAVE FEAO AND EXAMINEO THIS APPLICATION 1 STA�LS GARAGES ANO KNOW THE SAME TO BE TRUE AND CORREC7. ALl PROVISIONS Of �AWS yp�UAT10N SURTAX AND OROINANCES GOVERNING TMIS TYPE Of WORK WILI BE COMPLIEO $3 � �60• OU a��. • HS WITH WMETMER SPECIfIEO HEREIN Ofi NOT. TME GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTMOFI7Y TO VIOLATE OR CANCEI TH� pERMIT FEE SAC CMARGE PROVISIONS OF ANY 07MER STATE OR LOCAI LAW REGULATING CON- �9•I � 25 Fir SC �J� �%6 STRUCTION OR 7HE PERFORMANCE OF CONSTRUCTION PLAN CMECK FEE TOT FEE 102.89 S�GN4TUAE OF C �QACTOp 4UTMOA�2ED AGENT IDATE� E PRO VALIDATE THIS IS YO PERMIT� �r j�' � S�GNATUAEO�OWNEp��iOWNENBUILD@E1i iD�TE� 8 G�NS� � 06iE �'�.s , NEVV [ j ADDN [] ALTER [ ] Construction Address: � Legal Description: Owner Name 8� Address: Contractor: ��� � e.a..i�e��. �.-.�'1 C� r► /i _ LNING AREA: GARAGE AREA: DECK�A: OTHER: Construction CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ° BUILDING PERMIT APPLICATION Effective 1/1/2000 (763) 572-3604 Bld �nsp � , �I�' �G� ,✓� l ,�.F/'.,., � Tel. # %�� �^/��� MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed constn,iction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft� Length Width Height Sq. Ft —tength /�i Width � HgUGround Sq. Ft Cost: $ � 3 � � ° °7 �' Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: APPLICANT: Tel. # G CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ ��� o�� Fee Schedule on Reverse Side Fire Surcharge $ �.1 �0 .001 of Permit Valuation (1/10th%) State Surcharge $ % � � �J $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] TOTAL $ � � � � � l STIPULATIONS: �r��,.--. _ � BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,0� $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 �500,001 to $1,000,000 $1,000,001 and up FEFS $23.50 $23.50 for first $S00 plus $3.05 for each additional $1Q0 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional$1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,0� $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1, OQO or fraction thereof, to and including $1,000, 000 $5,608.75 for the first $1,000,000 pius $3.15 for each additional $1, 000 or fraction thereof DYtIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and replacement of curb and gutter and instali a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the constructioa site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has bee� ���tructed will be required before pr�eeding with the framing. New Houses Onlv � The Home Depot #2802, 5650 MAIN ST, NE, �ri Jul 28 15:04:40 2000 File saved as: f:�dn�decks�7280D331.DER �eck Lavout � �x I FRIDLEY, MN 55432, (612 � v f� __ . - _ _ _ . _ o. .. . .. , _ . - � Q a ���Q �� �'°� �-�D�� �a,vs �' / �a�� � C�/ � , d � _ � � 9�,� — o� � �J —� �v,�� % �`/�(c 2 .. / p�' , �,u 3/� �/L� �° • �,eav ors /�,v F� �s ����. , . ti���f, S ,� � �� �v�� �o . � • � � ` %� -o � �so �,bS' O� ,, !� -o �l�K �U�.Q� ° �=-�"oN ►��ax C��� a=o" � � :�.:�_ The Home Depot #2802, 5650 MAIN ST, NE, FRIDLEY, NIl�T 55432, (612 Fri Jul 28 14:48:45 2000 �File saved as: f:\dn\decks\7280D034.DER Post Layout for Deck 1 � � � �7� �3 � � �� � � N - O r� � �-� ,.,, ;, F�.��SN �'v�R �,�L � � M � ;,�XPOSFC E�T�I�i'LT� ; � � J � - � �„ OPENI�i ;� � " ..,..� �16' 2"16' 3 16' 2" �� , � 1' 3" � _ �� � � 2 "• Basel_int - - C tli � � �� --, � .� ■o � � r-I � 8� � o l � 3 �� � � N J The Home Depot #2802, 5650 MAIN ST, NE, FRIDLEY, �T 55432a (6�� Fri Jul 28 15:04:40 2000 - �The materials in this deck will cost $2320.78 File saved as: f:�dn\decks\7280D331.DE� 3D View APPROVED SUBJECT TO CONFORMANCE TO APPI,IC. CO S AND ORDINANCES. Bu 21G li�(SPECTQR CIT �� FRIDI�EY, i:'INNLSO�� �LASH r`J�R A�L EX�'OS�C EXT�RiOt; � O�Er���s�� ; � ; � .J � ,��ls���� " �y, ' U . -- � If l�� � �� D/t/ C� �'X � S�/-�- . _ %"`��/�`�' � . � _ q�ep� F �a�� �� - �oo� iti�D��ou �a viQ�d �: � The Home Depot #2802, 5650 MAIN ST, NE, FRIDLEY, MN 55432, (612) 571-9600 Fri Jul 28 15:04:58 2000 File saved as: f:\dn\decks\7280D331.DEK Construction Specifications Deck 1: Construction Method = Beam to Side ot Post Footing Type = In-Ground with Pier Live Load = 60 Dead Load = 10 Decking Spacing = 0.125 in Joist Spacing = 16 in Beam Spacing = 84 in Post Spacing = 92 in Decking = 5/4X6 .40 Sealed Southern Pine No. Beams = 2X12 .40 Treated Southern Pine No. 2 Joists = 2X10 .40 Treated Southern Pine No. 2 Posts = 4X4 .40 Treated Souttrern Pine No. 2 Deck Height = 24 in Diagonal Bracing = No Deck Skirt = No Joist Overhang = 12 in Beam Overhang = 12 in Decking Deflection Factor = 360 Joist Deflection Factor = 360 Beam Deflection Factor = 360 Pref Decking Size = Pref Joist Size = 2x10 Pref Beam Size = 2x12 Pref Post Size = 4x4 Stair 3: Step Width = 36 in Step Height = 24 in Step Rise = 8 in Step Run = 11 in Stringers = 2X12 .40 Treated Southern Pine (Vo. 2 Risers = 1 X6 .40 Treated Southern Pine No. 2 Treads = 5/4X6 .40 Sealed Southern Pine No. 1 Railing 4: Railing Height = 36 in Baluster Spacing = 3.75 in Post Spacing = 96 in Toe Space = 3.75 in Railing 3: Railing Height = 36 in Baluster Spacing = 3.75 in Post Spacing = 96 in Toe Space = 3.75 in Railing 5: Railing Height = 36 in Baluster Spacing = 3.75 in Post Spacing = 96 in Toe Space = 3.75 in Railing 2: Railing Height = 36 in Baluster Spacing .= 3.75 in Post Spacing = 96 in Toe Space = 3.75 in Railing 1: Railing Height = 36 in . ._ � � � The Home Depot #2802 - 5650 MAIN ST, NE, FRIDLEY, MN 55432 (612) 571-9600 Fri Jul 28 15:04:37 2000 Materials for Deck: Qty UOM SKU --------------------------------- 115 EA 557285 g FA 58941a 5 88 4 4 8 8 1 1 10 2 4 8 EA EA EA EA EA EA EA EA EA EA EA EA EA 365287 326626 831461 351792 184933 392960 161451 161451 162833 162825 162825 169405 351792 184933 Use Baluster Decking Decking Decking Decking Decking H Bottom Rail H Top Rail �edger Post Post Railing Post Stair Stringer Tread V Top Rail � � ����� Description 2x2x42" B1 E Railing Baluster PT 5/4x6x12 Prem hompsonized . PT #1 5/4x6x16 Prem Thompsonized .40 PT #1 5/4x6x8 Prem Thompsonized .40 PT #1 5/4x6x14 Prem Thompsonized .40 PT #1 5/4x6x10 Prem Thompsonized .40 PT #1 02x04x08 No. 2 Prime PT SYP .40 5/4x6x8 Standard SYP .40PT #2 2x10x8 Pressure Treated Y/P #Z 2x10x8 Pressure 1 reatetl Y/r �z 4x4x10 Pressure Treated Y/P #2 4x4x8 Pressure Treated Y/P #2 4x4x8 Pressure Treated Y/P #2 2x12x12 Pressure Treated Y/P #2 5/4x6x10 Prem Thompsonized .40 PT #1 02x04x08 No. 2 Prime PT SYP .40 41 EA 462047 2x10 Joist Hanger 2x10 Joist Hanger LUS210 3 EA 462047 2x12 Joist Hanger 2x10 Joist Hanger LUS210 8 EA 164365 4x4 Post Bracket 4x4 Adjustable Post Base ABA44 2 BX 735002 Baluster Screw 2 1/2" Grn Deckmate Screw 51b Box 16 EA 544208 Beam Bolts Carridge Bolt Galv 1/2"x 8" 16 EA 538892 Beam Nut Hex Nut Galv 1/2" 16 EA 538981 Beam Washers Flat Cut Washer Galv 1/2" 32 EA 929514 Concrete Pier Block 601b Q.uikrete Concrete Mix 8 EA 340721 Concrete Post Pad Dek-Block 4 4 BX 735003 Deck Screws 3" Grn Deckmate Screw 51b Box 4 EA 462$10 Hanger Nails 10D Joist Hanger Nails N10D 9 EA 228931 � Joist Nails 16d Gal Spiral P�L�I lai s ox aF Fn �j.R1Q'3$ JnisT nn rnn of Bea _ Hurricane Tie H-1 � Fn ___._. �.,Z Flashi 1 5/8x1 5/8 x8ft Alum ec Frdshing , 100 EA 928585 ____. Led er Bolt La Screw Galv 1/' x 100 EA 538981 Ledger Bolt Washer lat ut as er a v 40 EA 544208 Rail Post Bolts ----- Carridge Bolt GaEv 1/2"x 8" 40 EA 538892 Rail Post Nuts Hex Nut Galv 1/2" 40 EA 538981 Rail Post Washers Flat Cut Washer Galv 1/2" . 1 BX 734920 Step Screws 3" Grn Deckmate Screw 11b Box Materials Cost of Deck: S2320.78, plus sales tax Price Valid Today, 7/28/2000 This Estimate Guaranteed for 3 dayls) Parameters from UBC.cod parameter file. Parameters used for Deck 1: 60 psf live load, 48 inch footing depth. File saved as: f:\dn\decks\7280D331.DEK Warning: This is not a final design plan. Variations in building codes, specific architectural considerations, or site conditiuns may require changes to this design. You are responsible tor the final structure, code verification, material usage, and structural safety of this design. Be sure to check and verify the design wiih your local architect and building inspector. � : � �`° CONSUMER INFORMATION SHEET This wood has been preserved by pressure treatment with an EPA-registered pesticide containing chromated copper arsenate (CCA) to protect it from termite attack and decay. Wood treated with CCA should be used only where such protection is important. CCA penetrates deeply into and remains in the pressure-treated wood for a long time. Exposure to CCA may present certain hazards. Therefore, the following precautions should be taken both when handling the treated wood and in determining where to use or dispose of the treated wood. USE SITE PRECAUTION FOR CCA PRESSURE-TREATED WOOD * Wood pressure-treated with CCA preservatives may be used inside residences as long as all sawdust and construction debris are cleaned up and disposed of after construction. * Do not use treated wood under circumstances where the preservative may become a component of food or animal feed. Examples of such sites would be structures or containers for storing silage or food. * Do not use treated wood for cutting-boards or countertops. * Only treated wood that is visibly clean and free of surface residue should be used for patios, decks and walkways. * Do not use treated wood for constiuction of those portions of beehives which may come into contact with the honey. * Treated wood should not be used where it may come into direct or indirect contact with public drinking water, except for uses involving incidental contact such as docks and bridges. HANDLING PRECA,UTIONS FOR CCA PRESSURE-TREATED WOOD * Dispose of treated wood by ordinary trash collection or burial. Treated wood should not be burned in open fires or in stoves, fireplaces or residential boilers because toxic chemicals may be produced as part of the smoke and ashes. Treated wood from commercial or industrial use (e.g., construction sites) may be burned only in commercial or industrial incinerators or boilers in accordance with state and Federal regulations. * Avoid frequent or prolonged inhalation of sawdust from treated wood. When sawing and machining treated wood wear a dust mask. Whenever possible, these operations should be performed outdoors to avoid indoor accumulations of airborne sawdust from treated wood. * When power-sawing and machininq, wear goggles to protect eyes from flying particles. * After working with the wood, and before eating, drinking, and the use of tobacco products, wash exposed areas thoroughly. * If preservatives or sawdust ar.cumulates on clothes, launder before reuse. Wash work clothes separately from other household clothing. * Treated wood should be dry before handling. EPA Approved , �� sue�ecr P NO. City of Fridley 3 i 56� AT THE TOP OF THE TWINS g U i L D i N G P E R M I T i� � � � `v __��_ COMMUNITY OEVELOPMENT DIV. %� r � � PROTECTIVE INSPECTION SEC. / �� L--_- A��"' �•� CITY MALL FRIOLE� SSIJ2 NUMBEii nEV O�TE v�GE OF �nvqOVED Br L �� 612-571-3460 g�p.p�g 11/15/00 / / �oe aooaess 609 Cheryl Street NE t LEGAL �OT NO. BIOCK TRACT OF ADDtTION SEE ATTACNED oesca. 1,2,3,4 W Riverview Heights sNeer 2 PFOPEfiTY OWNER MAII ADORESS ZIP PNONE Pat/Gerald Kostohryz 609 Cheryl Street NE 763-783-1232 3 CONTRACTOF MAIL ADORESS 21P PMONE LICENSE NO Seal Guard Systems 3770 Dunlap Ave N, Arden Hills MN 55112 612-717-0700 a ARCHITECT OR DESIGNER MAIL ADORESS ZIP PMONE LICENSE NO. 20093688 S ENGINEER MAIL AODRESS 21P PHONE LICENSE NO 8 USE OF BUILDIN(i Residential 7 CIASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Replace windows 9 CHAN(iE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelliag per Section 310.9.1.2 of the 1997 Uniform Building Code. TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD SEPARA7E PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATIN(3, VENTI�ATING OR AIR CONDITIONING TNIS PEiiMIT BECOMES NULI AND VOIO IF WORK Oq CONSTRUCTION 20NING SQ. FT CU FT AUTMORIZED IS NOT COMMENCEO WITHIN 80 OAYS. OR IF CONSTqUCTION OR WORK IS SUSPENDED OR ABANDONE� FOii A PERIOD OF 120 DAYS AT ANY 71ME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OfFSTiiEET PARKING 1 HEREBY CERTIFY THAT I HAVE FiEAD AND EXAMINED TNIS APPLICA710N 1 S7ALLS GAiiAGES ANO KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ WITH WME7NER SPECIFIED HEREIN Op NOT. THE GRANTING OF A PERMIT y�S � H8O �2 . 9�F DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CHARGE PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGUTATING CON• � 12S . ZS Fir SC �S . HH STqUCTION OR 7ME PERfOqMANCE OF CONSTRUCTION PLAN CNEC E TOT FEE L e SC $ . $139.07 - S�GNOTUpE OF CON'AACTOp Op AUTHOp�ZEO oGENT IDATE� NE PROP VALIO TE 7MIS� O�J�� � � I � S�GNO�UAEO�OWNEA���OWNENBURDENi �D�TE� Bl G�NSP q6tE N� � � Effective 1/1/2000 ADDN [ j CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMITAPPLICATION Construction Address: l,� C� �f �r1 � 1 � . � , � Legal Description: Owner Name & Address:}�C�� � ��'G. � � � �°[�In � a � Tel. #��- �� - �,�j a Contractor: � G�� � c o�l � E�c.�n � �a V'�� MN LICENSE # 02(�(��q� �0 �� Address:�l�i U i� � � �, � � � �( � � 4 �1 � , 4 �� - � r I a- Tel. # �� I c� -� I '�l ' � 7 �Q LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTlON OF INlPRO�fEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft . Construction Type:_ -e �C�(`� �e P�� � s (1r) l�C� Estimated Cost: $ 5 � � O - � � Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ -$ DATE: � � - � �'dl� APPLICANT: � Tel. # (Q I�. -% I1 ` �%�� CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ 1 e� �- a� Fee Schedule on Reverse Side Fire Surcharge $ 5.� .001 of Permit Valuation (1/10th%) �fate Surc�iarge - $ � . �j � $:50/�,6��"Valuation --- - - -- — SAC Charge $ $1100 per SAC Unit License Surcharge $�J • C� $5.00 (State Licgnsed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] TOTAL $ I �j STIPULATIONS: /r���/�� /120�E � „� G�- ��� �d l i� 7` ���/•�/� �� �l � �'�'�//J mi(! liC. �vL'�,�,� �j� �"��!G���" ���- ��c=�lo. �. /.1� 191�� G��,.C_ i f� _ . . , i